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J Knee Surg 2021; 34(04): 434-443
DOI: 10.1055/s-0039-1697901
Original Article

A Comparison of Mobile- and Fixed-Bearing Unicompartmental Knee Arthroplasties in the Treatment of Medial Knee Osteoarthritis: A Systematic Review and Meta-analysis of 1,861 Patients

Fei Huang‡   *
1   Department of Orthopaedics, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
,
Dan Wu‡   *
2   Department of Outpatient, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
,
Jun Chang
1   Department of Orthopaedics, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
,
Chi Zhang
1   Department of Orthopaedics, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
,
Kunpeng Qin
1   Department of Orthopaedics, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
,
Faxue Liao
1   Department of Orthopaedics, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
,
Zongsheng Yin
3   Department of Orthopaedics, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
› Author Affiliations Funding This study is supported by the Natural Science Foundation of China (grant/award number: 81601974).
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Abstract

Many studies have compared mobile-bearing (MB) and fixed-bearing (FB) unicompartmental knee arthroplasties (UKAs) in patients with unicompartmental knee osteoarthritis (OA). The present systematic review and meta-analysis examined the differences in the clinical and radiological outcomes of MB UKA and FB UKA. PubMed, EMBASE, and Cochrane databases, as well as Google Scholar were searched for relevant studies. Randomized controlled trials (RCTs) and cohort studies that compared MB UKA and FB UKA were included. The weighted mean difference in the knee scores and range of motion (ROM) as well as the summary odds ratio of postoperative mechanical axis alignment, radiolucency, revision rate, and complications were calculated in the MB UKA and FB UKA groups. Finally, 2 RCTs and 11 cohort studies that involved 1,861 patients (1,996 knees) were included. The FB UKA group showed better postoperative Knee Society score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and ROM than the MB UKA group. However, the MB UKA group had more knees with a neutral limb alignment and a lower incidence of polyethylene wear than the FB UKA group. No significant differences were observed between the groups with respect to radiolucency, revision rate, and complications, such as arthritis progression, aseptic loosening, and postoperative pain. This meta-analysis has demonstrated that both prostheses provided excellent clinical outcomes and survivorship in patients with unicompartmental knee OA. The MB UKA group achieved the expected postoperative neutral limb alignment as compared with the FB UKA group, while the FB UKA group showed higher knee scores and superior ROM than the MB UKA group. Limited evidence is currently available; therefore, the results of our meta-analysis should be interpreted with caution.

Keywords

unicompartmental knee arthroplasty - osteoarthritis - mobile bearing - fixed bearing

* These authors have equal contribution to this work and should be considered as cofirst author.




Publication History

Received: 26 September 2018

Accepted: 26 July 2019

Article published online:
30 September 2019

© 2019. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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